[Efficacy of intravenous immunoglobulins in central pontine myelinolysis].

Abstract

INTRODUCTION:

Central pontine myelinolysis (CPM) is a neurological condition with unknown pathogenesis. It is most often observed in patients suffering hydroelectrolyte disturbances. There is no specific treatment and it can have an unfortunate outcome. We present a case of CPM that responded well to immunoglobulins.

CASE REPORT:

The case of a 31 year old female patient with bulimia, impulsive type personality, potomania and chronic alcoholism is presented. After admission to the intensive care unit due to severe hyponatremia (104 mEq/l) with correction in 7 days, she had a rapidly progressive picture of dysarthria and gait instability, tetraparesis and pyramidalism. Due to suspected CPM, emergency magnetic resonance imaging was requested, observing a hypertense lesion in central, bilateral and symmetric T2 of the pons. Treatment was initiated with dexamethasone with clinical progression so that i.v. immunoglobulin treatment was prescribed, with a spectacular improvement after the third day.

CONCLUSIONS:

Treatment with immunoglobulins may be a therapeutic option to consider in patients with CPM and clinical progression after the usual treatment. Furthermore, this response opens questions on a possible dysimmune mechanism in this disease.

• Authors: A B Escribano-Gascón, L I Casanova-Peño, M Bartolomé-Puras, J Porta-Etessam
• Journal: Neurologia (Barcelona, Spain) (Neurologia) 2008 Jul-Aug Vol. 23 Issue 6 Pg. 392-4 ISSN: 0213-4853 [Print] Spain
• Vernacular Title: Eficacia de las inmunoglobulinas intravenosas en la mielinolisis central pontina.
• PMID: 18597194 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Immunoglobulins, Intravenous

Topics

• Adult
• Female
• Humans
• Hyponatremia (complications)
• Immunoglobulins, Intravenous (therapeutic use)
• Myelinolysis, Central Pontine (etiology, immunology, pathology, therapy)